STUDY SESSION AGENDA

Transcription

1 STUDY SESSON AGENDA CTY COUNCL MEETNG CTY OF WHEAT RDGE, COLORADO Councl Chambers 7500 W. 29 th Ave. Mav :30 p.m. ndvduals wth dsabltes are encouraged to partcpate n all publc meetngs sponsored by the Cty of Wheat Rdge. Call Heather Geyer, Publc nformaton Offcer at at least one week n advance of a meetng f you are nterested n partcpatng and need ncluson assstance. APPROVAL OF AGENDA.L Staff Report( s) 2. mpact of Wheat Rdge Busness Dstrct 3. Debt Polcy and Unrestrcted Fund Balance Polcy 4. Ctywde Emergency Medcal Servces

2 Partners n avbrantwheat Rdge Wheat Rdge BUSNESS DSTRCT MEMORANDUM To: CTY COUNCL, MAYOR FROM: BRTTA FSHER, WR2020 CTY OF WHEAT RJOGE JOHN MARROTT, WRBD RE: MPACT OF WHEAT RJOGE BUSNESS DSTRCT MAy 10, 2011 Attached you wll fnd a map overvew and photo portfolo of the grants made by the Wheat Rdge Busness Dstrct. The portfolo demonstrates mpactful projects snce For ths study sesson, we wll focus on our recent mpacts and grants made snce January Regular Grants made: 12 Total amount granted: $72,244 Estmated total project costs on those 12 grants: $632,662 One Large Project grant wth CDBG contract: $60,000 Total project costs on large grant: $90,000 Grants pendng: 3 As Wheat Rdge Busness Dstrct has no staff and a volunteer board, we have a management agreement wth Wheat Rdge Ths has proven to be an effectve partnershp. n fact the Wheat Rdge 2020 loan and grant program have complmented one another n 5 very vsble projects on 38 th Avenue - Cress Ktchen & Bath, Lucky Pony Propertes (Bg Sky Espresso Cafe), Dary Queen Orange Julus, Molly Mare Propertes (Compass Constructon), and Tom Yang (Cebche). The total mpact of these fve projects s estmated at over $900,000. We wll dscuss the future drecton of the Wheat Rdge Busness Dstrct wth you on May 16. P.O. BOX 1268 WHEAT RDGE. CO WWWWHEATRDGE2020.0RG PH: FAX:

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4 Wheat Rdge Lanes 6595 W 38th Avenue Before After neat Rdge BUSNESS DSTRCT Fac;ade and Awnng mprovements Grant - $7,500 Total Project Cost Estmate - $17,000 January 2007 Map Locaton, " o r WheatR9ge

5 Jackson Hewtt 4385 Wadsworth Boulevard Before After Wheat Rdge BUSNESS DSTRCT Sgn mprovements Grant - $2,359 Total Project Cost Estmate - $4,709 June 2007 Map Locaton 2 Tar tyo f WheatR.;L.dge

6 Wheat Rdge Famly Clnc 6301 w 38th Avenue - Before After Sgn, Fac;ade, Awnng mprovements and Archtectural Assstance Grant - $14,000 Wheat Rdge BUSNESS DSTRCT Total Project Cost Estmated - $400,000 December 2007 Map Locaton 3 '" ", # O f Wheat Rl..-dge

7 Lakewood Plumbng 9800 w 44th Avenue Before After neat Rdge BUSNESS DSTRCT Sgn mprovement Grant - $3,000 Total Project Cost Estmate - $8,000 February 2008 Map Locaton 4.' < o r WheatRt-dge

8 DT 8955 W 44th Avenue Before After Wheat Rdge BUSNESS DSTRCT Fac;ade and Awnng mprovements Grant - $3,131 Total Project Cost Estmate - $6,324. Aprl 2008 Map Locaton 5,. rv tyof WheatRl.-dge

9 Cress Ktchen & Bath 6770 W 38th Avenue Before After WRBD Fac;ade, Sgn, and Awnng mprovements and Archtectural Assstance Grant - $14,000 WR2020 Buldng Up Busness Loan-$50,000 Total Project Cost - $175,000 completed January 2009 Wheat Rdge BUSNESS DSTRCT =rar, < tyof Wheatge

10 Amc's talan Restaurant 4300 Wadsworth Boulevard Before After Wheat Rdge BUSNESS DSTRCT Fac;ade, Sgn, and Awnng mprovements and Archtectural Assstance Grant - $12,348 Total Project Cost Estmate - $56,000 July 2009 Map Locaton 7 \. 10 4ra' jlyor WheatRe-ge

11 Bg Sky Espresso Cafe 7300 W 38th Avenue Before After WRBD Fac;ade, Sgn, and Awnng mprovements and Archtectural Assstance Grant - $11,000 WR2020 Buldng Up Busness Loan-$so,ooo Total Project Cost - $180,000 \.,V.lU d January 2009 &2 q Wheat Rdge BUSNESS DSTRCT '".., rar tyof WheatR9ge

12 Cone AppettjDary Queen 6790 w 38th Avenue Before After WRBD Fac;ade, Sgn, and Awnng mprovements Grant - $12,000 WR2020 Buldng Up Busness Loan - $50,000 Total Project Cost - $135,000 May 2009 Wheat Rdge BUSNESS DSTRCT (r 2llJ.C /... '",. O f W heat Rl..dge

13 Seyfer Automotve 4501 Harlan Street Before After Wheat Rdge BUSNESS DSTRCT Sgn mprovements Grant - $3,000 Total Project Cost Estmate - $9,140 Aprl 2009 Map Locaton 10 ", 4 :.P'c:lyof WheatRL-dge

14 Sandalwood Partnershp 3825 Harlan Street Before After Wheat Rdge BUSNESS DSTRCT Fac;ade, Sgn, and Awnng mprovements Grant - $10,070 Total Project Cost Estmate - $25, t November 2009 Map Locaton 1 1 :rp' jlyof WheatR9ge

15 The Growng Company 4830 Ward Road Before After Wheat Rdge BUSNESS DSTRCT Fa<;ade, Sgn, and Awnng mprovements Grant - $12,008 Total Project Cost Estmate - $48,652, < August 2010 Map Locaton 12 or WheatRL-dge

16 Super Car Wash 9500 W 44th Avenue Before After Wheat Rdge BUSNESS DSTRCT Sgn mprovements Grant - $3,000 Total Project Cost Estmate - $17,816 July 2010 Map Locaton 13 -rar.. # lyo f WheatR9ge

17 Lakesde Anmal Hosptal 4243 Harlan Street Before After Fac;ade & Sgn mprovements and Archtectural Desgn Grant - $11,000 Total Project Cost Estmate - $91,359 '< July 2010 Wheat Rdge BUSNESS DSTRCT Map Locaton 14 : lyof WheatRL..dge

18 Long Shots Bar & Grll 4400 Ward Road, Before After Wheat Rdge BUSNESS DSTRCT Fac;ade & Sgn mprovements Grant - $9,000 Total Project Cost Estmate - $19,777 May 2010 Map Locaton 15 ",. Of WheatRL-dge

19 Roger Loecher 4325 Wadsworth Boulevard - Before After Wheat Rdge BUSNESS DSTRCT Fac;ade mprovements and Archtectural Desgn Grant - $4,518 Total Project Cost Estmate - $10,134,, July 2010 Map Locaton 16 o r WheatRL..dge

20 Eleen Loecher (Black & Read ) 4335 Wadsworth Boulevard Before After Fac;ade & Sgn mprovements and Archtectural Desgn Grant - $6,725 Total Project Cost Estmate - $22,753 Wheat Rdge BUSNESS DSTRCT July 2010 Map Locaton 17 '" 4 rar jtyo f WheatR,gge

21 Led Fnancal Group W 43rd Drve Before After Wheat Rdge BUSNESS DSTRCT Sgn mprovements Grant - $3,000 Total Project Cost Estmate - $7,696 July 2010 Map Locaton 18.,. o r WheatRL-dge

22 Compass Constructon 7020 W 38th Avenue Before After WRBD Fac;ade, Sgn, and Awnng mprovements Grant - $10,100 WR2020 Buldng Up Busness Loan - $50,000 Total Project Cost - $175,000 March 2011 heat Rdge BUSNESS DSTRCT... \. : tyof WheatR;9ge

23 Patrck Nchols Assocates 7700 w 44th Avenue Before After Wheat Rdge BUSNESS DSTRCT Large Project Grant - $60,000 Total Project Cost Estmate - $90,000 February 2011 Map Locaton 20, Of Wheatdge

24 John Vllachca 9685 w 44th Avenue Before After Wheat Rdge BUSNESS CSTRCT Fac;ade and Archtectural Desgn Grant - $8,000 Commercal Exteror Pant Grant - $500 Total Project Cost Estmate - $205,200. '. September : 2010 tyo f WheatR9ge Map Locaton 21

25 Eleen Loecher (Jackson Hewtt/ Salsa's Mexcan Restaurant) 7610 W 44th Avenue Before After neat Rdge BUSNESS DSTRCT Fac;ade and Archtectural Desgn Grant - $8,000 Total Project Cost Estmate - $59,886 Aprl 2011 Map Locaton 22 4(P" lyor WheatRJe-ge

26 Styles Reynas Salon 5455 w 38th Avenue Antcpated completon August 2011 Before After Wheat Rdge BUSNESS DSTRCT Sgn Grant - $1,301 Total Project Cost Estmate - $ August 2011 Map Locaton 23, O f W h eat R-L..dge

27 Eleen Loecher (Advanced Transmsson) 7650 W 44th Avenue TRANSMSSON CENTER 2D ( Before After Wheat Rdge BUSNESS DSTRCT Fac;ade and Archtectural Desgn Grant - $6,900 Total Project Cost Estmate - $15,847 Aprl 2011 Map Locaton 24,. Of Wheatge

28 GA Rsk Management 9195 W 44th Avenue PROGRESSVE GA Rsk Management Before After Wheat Rdge BUSNESS DSTRCT Sgn Grant - $1,481 Total Project Cost Estmate - $2,961 March 2011 Map Locaton 25 :rar..., 4.P'Ctyof WheatRL-dge

29 Desgners Har Loft 7110 w 44th Avenue Antcpated completon May 2011 Before After Wheat Rdge BUSNESS DSTRCT Sgn Grant - $3,000 Total Project Cost Estmate - $7,910 Antcpated completon May 2011 Map Locaton 26,, : lyo r Wheatge

30 Thomas Yang 7000 W 38th Avenue Antcpated completon July 2011 Before After Fa<;ade & Sgn mprovements and Archtectural Desgn Grant - $9,953 Total Project Cost Estmate - $ Antcpated completon July 2011 Wheat Rdge BUSNESS DSTRCT Map Locaton 27 '" \ ;, O f WheatR.L..dge

31 A... Ctyof. " Wheatdge OFFCE OF THE ClY MANAGER ft/fyl 3. TO: FROM: Memorandum Mayor and Cty Councl Patrck Goff, Cty Manager DATE: May 11,2011 SUBJECT: Debt Polcy and Unrestrcted Fund Balance Polcy A top prorty n the 2010/2011 Wheat Rdge Strategc Plan s the development of a long term fnancal sustanablty plan whch s an acton tem under the goal of "Fnancally Sound Cty Provdng Qualty Servces." n 2010, the Cty contracted wth Clfton Gunderson to conduct a "Fnancal Checkup" of the Cty's current fscal condton. The Fnancal Checkup utlzed eghteen (18) ndcators coverng areas such as revenues, expendtures, cash lqudty, unrestrcted fund balance rato as well as other key ndcators to dentfy sgnfcant trends and "red flags" that may mpede long-term fnancal stablty. On August 16,2010, staff presented the results of the "Fnancal Checkup" to Cty Councl. Staff prortzed the recommendatons from the report and contracted wth Clfton Gunderson to draft a Debt Management Polcy and an Unrestrcted Fund Balance Polcy. Clfton Gunderson and staff wll present both draft polces to Cty Councl at the May 16 th study sesson. Attachments: 1. Draft Debt Management Polcy 2. Draft Unrestrcted Fund Balance Polcy

32 Cty of Wheat Rdge Debt Management Polcy The Cty of Wheat Rdge (Cty) recognzes the mportance of long-range, fnancal plannng n order to meet ts captal project and mprovement needs. The followng debt management polcy provdes gudance on the ssuance of debt to help ensure that the Cty mantans a sound debt poston and that ts credt qualty s protected. As such, the polcy allows for an approprate balance between establshng debt parameters whle also provdng flexblty to respond to unforeseen crcumstances and new opportuntes. Responsblty and Admnstraton of Polcy The prmary responsblty for developng long-term, fnancng regommendatons rests wth the Cty Manager. Durng the annual budget process, and at an t er tme durng the year that may be warranted, the Cty Manager wll work wth the Ad. 'stratve Servces Drector and the Cty Treasurer (the nternal workng group) to det. mne f re s a need for long-term fnancng consderaton. As part of the determnaton ocess, the ernal workng group shall revew the fnancng needs outlned by the Capta' 1m rovement Program (see below) to analyze the captal fnancng needs compared wth v.al Ble resources. The nternal workng group wll also provde recommendatons regardng r fundng and restructurng of exstng debt. The Cty Manager and Ct asurer wll revew the Debt Management Polcy annually n connecton wth the Cty's annual budget process to ensure that the Cty s adherng to the framework outlned n ths polcy and wll make recommendatons to revse the polcy as needed. Captal mprovement Program The Captal mprovement Program (CP) wll be utlzed to dentfy captal projects and/or mprovements that are part of the Cty's strategc vson and economc development efforts. The CP wll cover, at a mnmum, a ten (10) year perod and provde a projecton of the fnancng needs requred to mplement the CP. The CP wll nclude the assocated ongong operatons and mantenance costs of such captal assets and/or mprovements so that the total costs of the projects are consdered. The CP wll be updated annually by the Cty's Publc Works' Drector as part of the budget process. Attachment 1

33 Purpose of Debt ncurrence of debt or long-term borrowng wll only be used for the purpose of provdng fnancng for captal assets, whch nclude but are not lmted to buldngs, nfrastructure, land acquston and purchase of sgnfcant equpment. The Cty, under no crcumstances, wll ssue debt or borrow funds to fnance Cty operatons and mantenance costs. The Cty wll strve to maxmze the use of pay-as-you-go fnancng for captal projects and mprovements. Debt borrowng wll be consdered when annual revenues and accumulaton of fund balances are not suffcent to provde the necessary fundng for such projects. Types of Debt The types of debt nstruments to be used by the Cty may e o o o o o General Oblgaton and Revenue Bond Short-term notes Specal or Local mprovement bonds Certfcates of Partcpaton Any other legally recognzed s cl:.lrty by Cty Councl Although permtted antcpaton notes. arket condtons favor ths type of ssuance, and when feasble, ensure the e s a max nt rest rate provded wthn the varable rate structure. Credt enhancements be used 0 y n nstances where the antcpated present value savngs n terms of reduced ntere expe se exceeds the cost of the credt enhancement. level of Debt The Cty's aggregate amount of bonds or other evdences of ndebtedness outstandng wll not exceed three percent (3%) of the actual valuaton of the taxable property wthn the Cty as shown by the last precedng assessment. n determnng the amount of ndebtedness outstandng, the Cty wll adhere wth the computaton gudelnes as establshed by Cty Charter. The Cty wll strve to mantan ts annual debt servce costs (prncpal and nterest) for ts governmental actvtes at a level of no greater than ten percent (10%) of general fund expendtures. The repayment terms of the debt wll not exceed the useful lfe of the captal asset fnanced. Further, the Cty wll seek level or declnng debt repayment schedules and wll not ssue debt that provdes for a balloon prncpal payment reserved at the end of the term of

34 the ssue. Moreover, the Cty wll also strve to obtan redempton terms that allow for the prepayment of debt wthout payng a redempton penalty. Debt ssuance Practces As part of ts debt ssuance process, the Cty wll at all tmes manage ts debt and sustan ts fnancal poston n order to secure and mantan an Aa/AA or hgher bond ratng. The Cty wll market ts debt through the use of a compettve bd process when ssung general oblgaton debt. The compettve bd process wll also be used for other debt ssuances unless tme, nterest rates and/or other factors make t more favorable for the Cty to use a negotated process. f needed, the Cty wll hre an ndependent fnancal advsor, a provder (e.g. bond counsel), to assst n the structurng of t overall gudance throughout the process. any other professonal servce bt transacton and to provde Gudelnes for Refundng The Cty shall consder refundng (advance an analyss ndcates the potental for net pr sa (3%) can be acheved. The Cty may also exstng restrctve covenants. plannng. The Cty wll nvest ts deb oceeds n accordance wth the Cty's nvestment polcy and statutory requrements. Funds wll be nvested n nstruments and wth related maturtes that wll provde the lqudty needed to meet the cash flow needs of each project. n ths regard, the Cty Treasurer wll prepare a cash flow projecton to determne the avalablty of funds avalable to be nvested and ther respectve requred maturtes. The Cty wll comply wth all arbtrage rebate requrements as establshed by the nternal Revenue Servce. Arbtrage wll be calculated at the end of each fscal year and nterest earned on the nvestment of debt proceeds wll be reserved to pay any penaltes due. Secondary market dsclosures requrements establshed wthn the terms of the debt transacton wll be adhered to and fled on a tmely bass. The Cty Treasurer wll be responsble for managng the post ssuance requrements lsted above and/or cause any post ssuance requrements to be completed.

35 Cty of Wheat Rdge Unrestrcted Fund Balance Polcy The Cty of Wheat Rdge (Cty) has determned t to be a sound, fnancal practce to mantan adequate levels of unrestrcted fund balance n ts General Fund n order to mtgate current and future rsks such as revenue shortfalls and unantcpated expendtures as well as to ensure stable tax rates. Addtonally, the Cty beleves that adequate unrestrcted fund balance levels are a crtcal consderaton to the Cty's long-term fnancal plannng. n ths regard, the Cty has establshed the followng fscal polcy related to ts unrestrcted fund balance. Maxmum and Mnmum Amounts The Cty wll mantan a mnmum unrestrcted fund balao of at least two months or approxmately 17%, as recommended by the Government F a Ee Offcer' s Assocaton (GFOA), of ts General Fund operatng expendtures. The Cty' unrestrcted fund balance shall not exceed 35.0% of General Fund opera expendtll s. Not precludng the aforementoned mnmum and maxmum percent ge, the (S ty wll an ually target to mantan a 25.0% unrestrcted fund balance percentage level ga of ts annual budget process. Use of Funds Whle targetng to mantan an ann there may be crcumstances tha. arra has establshed the followng l'-lst nce u apprpprated costs to servce and mantan current Cty o Unexpecte on-budgeted emergences, natural dsaster costs, and/or ltgaton sut o Grant matchng o Early retrement of debt o To cover defcts n other funds due to a shortfall n budgeted revenues o Captal asset acquston, constructon and mprovement projects The use of the unrestrcted fund balance for the above permtted events wll requre a majorty vote by Cty Councl wth the excepton of captal asset acquston, constructon, and mprovement projects, whch wll requre a super majorty vote. Attachment 2

36 Terms for Replenshng n nstances where the Cty elects to use ts unrestrcted fund balance for captal asset acquston, constructon and mprovement projects, the Cty shall replensh the unrestrcted fund balance to ts prevous levels as soon as possble, but only after the Cty's current operatonal needs are met, and n no case, more than two years subsequent n whch the unrestrcted fund balance was used. For any and all other nstances, as permtted by ths polcy, n whch the Cty elects to use ts unrestrcted fund balance, the Cty wll replensh the unrestrcted fund balance as soon as revenues are avalable, but only after the Cty's current operatonal needs have been met. Excess Funds n the event the Cty has accumulated ts permtted, max 40.0%, the Cty, at the dscreton and determnaton of CtY Cou desgnate such excess funds for the followng purpose. unrestrcted fund balance of c and the Cty Manager, wll o o o Reserves for equpment replacement Repar and mantenance of Cty, faclte Fundng of nfrastructure mp Revew of polcy The Cty Treasurer wll revew Unrestrcted Eund Balance Polcy annually n connecton wth the Cty's annual budgetng,j2rocess t ensure Hat the Cty s mantanng adequate unrestrcted fund balance levels. Ad ton y a st every three years, the Cty Manager wll revew the polcy and wll mak ton for modfcaton as deemed approprate. Ths polcy t forth by the GFOA. As such, any updates ssued by the he Cty Manager when makng recommendatons for modfcatons to ths polcy.

37 J.. Cty of " Wheatge O..CE DEPARTMENT Memorandum JfenL 4. TO: VA: FROM: DATE: Mayor DTullo and Cty Councl Patrck Goff, Cty Manager Danel Brennan, Chef of Polce Joe Cassa, Dvson Commander May 9, 2011 (for the May 16 Study Sesson) SUBJECT: Ctywde Emergency Medcal Servces SSUE: The Cty of Wheat Rdge s served by four fre protecton dstrcts. On July 25, 1988, the Cty of Wheat Rdge, by Councl Resoluton, assumed the responsblty of provdng Emergency Medcal Servces (EMS) throughout the Cty, due to concerns about the level of care provded by volunteer fre departments. Based upon servce delvery concerns, Cty Councl made a polcy decson to have the Cty provde emergency medcal servces by contract wth a prvate vendor at no cost to the Cty of Wheat Rdge wthn the boundares of the Wheat Rdge Fre Protecton Dstrct. Cty Councl desgnated the Polce Department to oversee ths program. Snce that tme, the Cty has contracted EMS servces through a compettve bd process, and the contract now ncludes the provson of EMS servces throughout the Cty. These contracts have been assgned n fve-year tme ncrements. The current contract wth Prdemark Ambulance Servce expres on January 23, Commander Joe Cassa and have met wth staff representatves from each fre protecton dstrct to dscuss the role of the Cty n provdng overall EMS servces for the Cty, as well as each fre dstrct's vson of EMS servces wthn ther respectve dstrcts. The Arvada and Wheat Rdge Fre Protecton Dstrcts both ndcated a desre to assume responsblty for EMS servces n ther respectve dstrcts n the near future. The West Metro Fre Protecton Dstrct has a longstandng hstory of provdng EMS servces n ther dstrct, and wll contnue to do so. The Farmount Fre Protecton Dstrct expressed a strong desre to mantan the current EMS servces contract. PROR ACTON: On August 1, 1988, the Cty of Wheat Rdge assumed the responsblty of provdng Emergency Medcal Servces (EMS) throughout the Wheat Rdge Fre Protecton Dstrct as a polcy.

38 Staff Report: Ctywde Emergency Medcal Servces May 9, 2011 Page 2 FNANCAL MPACT: There are no hard dollar costs assocated wth the Cty contractng EMS servces. There are monthly soft dollar costs related to the tme Department staff spends attendng monthly meetngs. These meetngs nclude the current EMS provder and representatves from the fre protecton dstrcts. BACKGROUND: The Cty of Wheat Rdge s served by four fre protecton dstrcts: (1) Wheat Rdge Fre Protecton Dstrct (WRFPD), (2) Arvada Fre Protecton Dstrct (AFPD), (3) West Metro Fre Protecton Dstrct (WMFPD), and (4) the Farmount Fre Protecton Dstrct (FFPD). The Cty currently conssts of square mles, wth WRFPD servng 7.66 square mles; AFPD servng 2.58 square mles; FFPD servng 0.39 square mles, and WMFPD servng 0.29 square mles. n early 1988, the Wheat Rdge Fre Protecton Dstrct Board (WRFPD) announced that the volunteer-run ambulance servce would dscontnue transport of EMS patents as of July 31, Ths announcement was the result of a number of patent care concerns to nclude: Only 35% of the EMS runs made by the volunteer ambulance crews were staffed wth paramedcs. A lack of volunteer fre EMS personnel coverage durng the day and delayed responses throughout the late evenng and early mornng hours. A response tme of the ambulance crews rangng from ffteen to twenty-fve mnutes, wth the response tme defned as the tme the call was receved to the tme the ambulance arrves on scene. At that tme, the standards of adequate response tme around the naton called for eght mnutes or less. The ssue of pad EMS personnel was dscussed and the WRFPD phlosophy at that tme was to contnue volunteer servces, because of the costs nvolved and ther belef that ther servce was adequate. As a result, an Emergency Medcal Servces Board was formed to educate the publc and resolve the problems of the extended response tmes and the avalablty of fre personnel traned as paramedcs. The Board conssted of the head of emergency servces at Lutheran Medcal Center, the Wheat Rdge Fre Protecton Dstrct, Cty offcals and Cty resdents. On July 25, 1988, Cty Resoluton Number 1102 was passed by the Cty Councl, whch resulted n an ntergovernmental agreement between the Cty, the Wheat Rdge Fre Protecton Dstrct, and Ambulance Servce Company to provde emergency ambulance servces to resdents resdng wthn the Cty of Wheat Rdge and the Wheat Rdge Fre Protecton Dstrct. On October 24, 1995, an ntergovernmental agreement between the Cty, Wheat Rdge Fre Protecton Dstrct, and the Amercan Medcal Response of Colorado, nc. (AMR) was entered nto. The agreement was the result of AMR purchasng the Ambulance Servce Company. The term of ths agreement was for a sngle year, wth the provson of yearly renewal for the followng four years. n 1996, there were multple ambulance provders respondng to a sngle call for emergency

39 Staff Report: Ctywde Emergency Medcal Servces May 9, 2011 Page 3 medcal servces wthn the Cty. As a result, there were unsafe response practces by ambulance provders. The ssue prompted a draft of an ordnance to amend the Cty Code of Laws to provde the addton of a new secton. The new secton would have provded the response of a sngle emergency ambulance servces provder for those calls receved by the Polce Department. There was no Cty Councl acton taken on ths matter. n part, ths was the result of the four fre protecton dstrcts servng the Cty. On December 27, 1999, an ntergovernmental agreement between the Cty, Wheat Rdge Fre Protecton Dstrct and Prdemark Paramedc Servces, LLC was completed. Ths agreement was the result of performance ssues nvolvng AMR to nclude nteragency communcaton and cooperaton. The term of ths agreement was the same as s reflected n the AMR agreement. On January 23, 2006, an ntergovernmental agreement among the Cty of Wheat Rdge, the Wheat Rdge Fre Protecton Dstrct, and Prdemark Paramedc Servces, LLC for the provson of emergency ambulance servces wthn the entre corporate lmts of the Cty of Wheat Rdge, and the boundares of the Wheat Rdge Fre Protecton Dstrct, was wrtten. The WRFPD partcpated n the Request for Proposal process, ntervews and the draftng of the GA. The term of the agreement was from January 2006 through January 2007, wth the provson of yearly renewal for a perod of fve years. Ths agreement wll expre on January 23, Throughout Commander Cassa's current assgnment to the Patrol Operatons Dvson, he has been the charperson for the Cty Response Revew Commttee for emergency medcal servces. As establshed n the GA, the purpose of ths commttee s to act n an advsory capacty only as to the operatonal and admnstratve terms contaned wthn the GA. The performance measures wth regard to response tme have been amended over tme, wth nput from all commttee members, and currently requre an emergency response tme of sx mnutes at the 90% fractle and a non-emergency response tme of ten mnutes at the 90% fractle. The current GA conssts of the followng sectons: Terms and Condtons Communcatons Medcal Supervson Helcopter Crme Scene Control Tranng Equpment Company Employees Term (establshes an annual performance evaluaton by the Cty Councl and the Wheat Rdge Fre Protecton Dstrct) Assgnment Polcy (establshes the response revew commttee) Lablty nsurance A copy of the current GA s attached for your revew as well as copes of the last three yearly performance evaluatons

40 Staff Report: Ctywde Emergency Medcal Servces May 9,2011 Page 4 The Response Revew Commttee s structured to allow actve partcpaton by the agences that are partes to the GA on a monthly bass. A typcal commttee meetng s attended by Prdemark personnel, to nclude the Operatons and/or the Clncal Drectors; Wheat Rdge Fre Protecton Dstrct personnel, to nclude the Fre Chef and/or hs desgnee; West Metro Fre Protecton Dstrct personnel, to nclude the Dvson Chef of Communcatons and the Assstant Communcatons Manager; Wheat Rdge Polce Department personnel, to nclude the Patrol Operatons Dvson Commander, the Communcatons Center Manager, and the Lead Emergency Servces Specalst. The meetng agenda typcally nvolves the revew of Prdemark Paramedc response tmes of both prorty one calls (emergency response) and prorty two calls (non-emergency response). Those response tmes that do not meet the GA requrements are dscussed n detal, and a plan s agreed to by commttee members regardng the soluton(s) to the extended response tmes. Ths presentaton and dscusson s followed by a round table dscusson wth those present to nclude follow up from prevous meetngs and/or other noteworthy events. Both the Arvada and Farmont Fre Protecton Dstrcts are nvted to partcpate and do so on an occasonal bass. The Polce Department provdes an admnstratve person to take meetng mnutes. A revew of the EMS servces provded by Prdemark and the Wheat Rdge Fre Protecton Dstrct, as reflected n the annual performance evaluatons, s demonstrated n the followng table: Agency Prdemark Wheat Rdge Fre Protecton Paramedcs Dstrct EMS Calls: ,338 Not Reported 2008 Transports 2,297 Not Applcable A vg Emergent Response Tme 3:20 4:35 EMS Calls: ,260 3, Transports 2,609 Not Applcable A vg Emergent Response Tme 3:37 4:49 EMS Calls: ,207 2, Transports 2,449 Not Applcable A vg Emergent Response Tme 3:52 4:21 t should be noted that the Cty experences more than one EMS call for servce at the same tme on a frequent bass (call surge capablty). Ths stuaton requres multple ambulance crews and related equpment to respond wthn the Cty at the same tme. n more serous EMS calls, t s not unusual to requre more than one ambulance crew and related equpment to the same scene (e.g., njury traffc accdents, and major crtcal ncdents that often requre multjursdctonal responses). Commander Cassa and met wth staff representatves from each of the fre protecton dstrcts

41 Staff Report: Ctywde Emergency Medcal Servces May 9, 2011 Page 5 to dscuss the roles of ther fre dstrct and the Cty n provdng overall EMS servces wthn ther respectve dstrcts n an effort to determne each dstrct's short and long-term vson about provdng EMS servces wthn ther dstrcts. Wheat Rdge Fre Protecton Dstrct The followng s a summary of a meetng wth Wheat Rdge Fre Chef Gllespe regardng the provson of EMS servces wthn the WRFPD. Currently, 85% of all frefghters are traned at the Emergency Medcal Techncan - Basc level. As ther department transtons to career frefghter personnel, they wll be requred to obtan paramedc certfcatons wthn 36 months of hre. Volunteer frefghters wll be requred to mantan EMT - Basc certfcatons. Average response tme on emergency EMS calls: 4:21 n WRFPD plans to staff two paramedcs on each fre apparatus no later than Chef Gllespe's vson s to have each fre apparatus staffed at an Advanced Lfe Support level. Chef Gllespe envsons an EMS model, based on the Aurora Fre Department model for the Wheat Rdge Fre Protecton Dstrct. n summary, each fre apparatus s staffed wth paramedc frefghters. The Fre Department contracts wth a prvate transport vendor that provdes Basc Lfe Support and Advanced Lfe Support transports. Chef Gllespe's desre s for the WRFPD to be the sole admnstrator and a provder of EMS servces wthn the boundares of ther dstrct by He would prefer that contracts wth ambulance servces be a responsblty of the Dstrct and not the Cty. WRFPD uses Dr. Beckman at the Exempla Lutheran Hosptal as ther agency's medcal drector to oversee polces and protocols related to EMS servces. Chef Gllespe's stated goal s to provde fre and EMS servces wthn four mnutes, 100% of the tme. Chef Gllespe has provded an Executve Summary of a consultant's study regardng EMS servces as part of hs agency's busness plan n terms of movng towards beng an EMS servce provder. The busness plan descrbes how the dstrct wll delver ALS servce usng fre engnes. WRFPD understands that the Cty reserves the rght to provde EMS servces, and they wll contnue to work cooperatvely wth the Cty and ts Polce Department on EMS servlces. Arvada Fre Protecton Dstrct The followng s a summary of a meetng wth Arvada Fre Chef Jon Greer and hs staff regardng the provson of EMS servces wthn the AFPD. All frefghters are EMT - Basc certfed. The Department currently has 12 paramedcs staffng four of the agences eght fre engnes. Future plans are to staff at least 5 of the 8 statons wth paramedcs. Average response tme on emergency EMS calls: 3 :27 Chef Greer envsons provdng EMS transport servces no later than March, 2013.

42 Staff Report: Ctywde Emergency Medcal Servces May 9, 2011 Page 6 The Dstrct's current busness plan s to run three EMS ambulances and contract wth an ambulance provder for backup responses. There would be three ambulances postoned at three fre statons and three ALS engnes placed at three other fre statons. Arvada Fre wll have two more ambulances n reserve, located at Statons 7 and 8 that wll be crossstaffed when needed n the case of more than three EMS calls occurrng at once. AFPD understands that the Cty reserves the rght to provde EMS servces, and they wll contnue to work cooperatvely wth the Cty and ts Polce Department on EMS servces. West Metro Fre Protecton Dstrct The followng s a summary of a meetng wth West Metro Fre Chef Doug McBee and hs staff regardng the provson of EMS servces wthn the WMFPD. WMFPD has 335 personnel, 220 are traned as paramedcs and the remanng staff have EMT - Basc certfcatons The Department has 18 paramedc ambulances. They normally staff ther dstrct wth 9 to 11 ambulances. There s always an on-duty EMS supervsor. Chef McBee noted that fre and EMS assocatons state that an acceptable response tme standard for emergency calls for medcal servces s 8 mnutes, 90% of the tme. All fre apparatus are ALS equpped. The Dstrct's phlosophy s to send an ambulance and fre truck to every call for servce. WMFPD understands that the Cty reserves the rght to provde EMS servces and they wll contnue to work cooperatvely wth the Cty and ts Polce Department on EMS servces. WMFPD's preference s to be the sole provder of EMS servces wthn ther dstrct. Farmount Fre Protecton Dstrct The followng s a summary of a meetng wth former Farmount Fre Chef Don Angell and hs staff regardng the provson of EMS servces wthn the FFPD. The Department has 21 full-tme personnel and 65 volunteers. One hundred percent of the Department's full-tme staff are certfed as EMT - Basc or hgher. Eghty-fve percent of the volunteers have EMT - Basc certfcatons. The Department does not antcpate staffng paramedcs on fre apparatus due to economc costs nvolved. n addton, the agency does not respond to enough EMS calls to requre paramedc certfcatons for ther frefghters. The agency wll contnue to requre EMT - Basc certfcaton for all pad and volunteer personnel. FFPD favors a contnuaton of EMS servces through Prdemark Ambulance Servces or a smlar ambulance servce vendor. FFPD s satsfed wth the current system, ncludng the contnuaton of the Cty of Wheat Rdge beng the contractor of those servces. FFPD has some reservatons n assumng responsblty for EMS servces n ther dstrct. n summary, the West Metro Fre Protecton Dstrct has a long hstory of provdng emergency medcal servces and transports wthn ther dstrct. Leadershp wthn the Arvada and Wheat Rdge Fre Protecton Dstrcts envson provdng BLS and ALS servces, although ther

43 Staff Report: Ctywde Emergency Medcal Servces May 9, 2011 Page 7 tmeframes dffer on when they would start offerng servces. AFPD wll have transport vehcles, whle WRFPD wll contract wth an ambulance transport servce. The Farmount Fre Protecton Dstrct wll contnue to operate wthout paramedcs, and wll rely on a contracted servce wth an ambulance servce to provde advanced and basc lfe support servces. LEGAL REVEW Cty Attorney Gerald E. Dahl authored a memorandum on December 22, 2008 regardng the legal oblgatons of the Cty to provde ambulance or emergency medcal servces. Mr. Dahl noted that nether the State Consttuton nor the Cty Charter menton, or requre a muncpal duty to provde these servces. Mr. Dahl notes that State Statute authorzes a muncpalty to adopt rules and regulatons n furtherance of publc health, safety and welfare. ALTERNATVES The Polce Department has dentfed the followng alternatves for Cty Councl consderaton: 1. Contnue wth the current process of the Cty contractng wth a prvate vendor to provde EMS servces wthn the corporate lmts of the Cty. The Polce Department would oversee ths process for the entre Cty and mantan monthly meetngs to ensure servce levels specfed n the GA are met. The department has planned to add performance measurements to any future GA. 2. Allow the four fre protecton dstrcts to provde EMS servces wthn ther dstrct boundares. Because of past hstory n ths area, the Polce Department would recommend some servce performance expectatons be establshed to ensure consstent and professonal servces. 3. The Cty mantans an EMS contract wth a prvate contractor, whle Arvada and Wheat Rdge Fre Protecton Dstrcts tran EMS paramedc personnel to staff ther fre apparatus and submt a complete busness plan for revew by the Polce Department and Cty Councl before further actons are taken. A cutover date would need to be establshed. RECOMMENDATONS: Commentares on emergency medcal servces today note that whle the response tme related to EMS servces s mportant, what s more mportant s the nterventon and level of care provded by traned and experenced paramedcs. Councl has been provded wth an annual report related to the current EMS servces provsons wth Prdemark Ambulance Servces, whch ncludes a thorough revew of the contract provsons. Prdemark Ambulance Servce contnues to meet ts contractual oblgatons. Staff recommends the Cty, through the Polce Department, contnue to provde EMS servces va a contract wth a prvate ambulance servce untl each fre protecton dstrct has submtted a complete busness plan for Cty Councl consderaton to assume approprate EMS servces wthn ther dstrct. Dscussons can occur regardng the content of the busness plan. n the nterm, the Response Revew Commttee can meet to agree upon performance standards for the

44 Staff Report: Ctywde Emergency Medcal Servces May 9, 2011 Page 8 next EMS contract. Snce West Metro Fre Protecton Dstrct provdes ALS and BLS servces, staff recommends ths agency be excluded from ths requrement. Farmount Fre Protecton Dstrct has several optons avalable to ther dstrct n ths area regardng EMS servces. JC: DB ATTACHMENTS: 1. Wheat Rdge Fre Protecton Dstrct Emergency Medcal Servce: Analyss of nfrastructure and On-Gong Management 2. Cty of Wheat Rdge and Wheat Rdge Fre Protecton Dstrct ntergovernmental Agreement wth Prdemark Ambulance Servce ,2009 and 2010 Yearly GA Evaluatons Ordnance

45 Wheat Rdge Fre Protecton Dstrct Emergency Medcal Servces Analyss of nfrastructure and On-Gong Management GEMS BOK CONSULTNG May 2, 2011 Prepared by: Gemsbok Consultng, nc., 523 Park Pont Drve #360 Golden, CO Phone: Fax: gemsbokconsult ng.com,., l ", Vour v:,-oll. Our /wllrgemll1t t(/()/. Attachment 1

46 Wheat Rdge Fre Protecton Dstrct Analyss of nfrastructure and On-Gong Management Executve Summary Wheat Rdge Fre Protecton Dstrct (WRFPD), n keepng wth many fre organzatons across the naton, s expandng ts servce model to nclude Emergency Medcal Servces (EMS). Ths ncludes havng fve (5) Advanced Lfe Support (ALS) apparatus onlne by December 31, EMS transports wll contnue utlzng a thrd-party ambulance provder. Ths report s an analyss of the EMS nfrastructure, mplementaton of ALS apparatus and the on-gong successful management of the EMS system for WRFPD. The nfrastructure of EMS to be adopted by WRFPD, the tmelne to accomplsh ths ntegraton and the benefts to the communty wll be outlned n the report. Addtonally, ths report explores how to best manage a thrd-party EMS transport provder to ensure the best system possble for the communty served. n ths report, EMS refers to care provded to a patent from the moment a call s receved and personnel frst arrve on the scene through transportng of a patent to the hosptal. Not all EMS calls requre transport servces, but are stll consdered EMS calls f medcal care s provded. EMS care ncludes both Basc Lfe Support (BLS) and Advanced Lfe Support (ALS) regardless of a transport outcome. The actual process of transportng a patent to the hosptal s one pece of the process wthn EMS and s currently provded by Prdemark Paramedc Servces, LLC (Prdemark). Another crtcal term used n ths report s medc unt versus ambulance. Although both terms descrbe a unt that can transport a patent to a hosptal, the medc unt, s staffed wth fre personnel and equpment to respond to all calls. For example, the medc unt can assst wth fre, hazmat, and the other crtcal functons of a fre department. An ambulance s typcally only able to respond to medcal calls and does not carry the addtonal equpment for other types of ncdents. EMS nfrastructure One of the most essental publc 'safety functons provded by the fre servce s prehosptal emergency response. The Federal EMS Act of 1973 defned an EMS system as "an entty that provdes for the arrangement of personnel, facltes, and equpment for the effectve and coordnated delvery of health care servces under emergency condtons n an approprate geographc area" (EMS Act 1973, (P.L ). Fre Departments that have Advanced Lfe Support (ALS) EMS systems are strategcally postoned to delver tme crtcal response and effectve patent care. When EMS s provded by frefghter paramedcs "they are capable of smultaneously securng a scene, mtgatng the hazard, and trage, extrcatng, treatng, and decontamnatng... the patent. There s no servce more capable of rapd mult-faceted response than a fre-based EMS system,,2. 1 Prehosptal Emergency Medcal Response: The Role of the Unted States Fre Servce n Delvery and Coordnaton 2 Fre Servce-Based EMS Advocates WRFPD EMS: Analyss of nfrastructure and On-Gong Management 2/ P a g e

47 Wheat Rdge Fre Protecton Dstrct Analyss of nfrastructure and On-Gong Management There are many dfferent models that can be adopted to provde Fre-Based EMS. The three general structures accordng to an nternatonal Assocaton of Frefghters (AFF) 2007 whtepaper nclude 3 : a. Fre servce-based system usng cross-tranedjmult-role frefghters. Frefghters are all-hazards responders, prepared to handle any stuaton that may arse at a scene ncludng patent care and transport. -. b. Fre servce-based system usng employees who are not cross-traned as fre suppresson personnel. Sngle role EMS-traned responders accompanyng f refghter frst-responders on emergency medcal calls. c. Combned system usng the fre department for emergency response and a prvate or "thrd servce" provder for transportaton support. Sngle role emergency medcal techncans and paramedcs accompany frefghter frst responders to emergency scenes to provde patent transport n a prvate or thrd servce ambulance. Currently, WRFPD responds to all ALS (Prorty ) calls along wth Prdemark, who provdes the ALS certfed personnel and transport unt. WRFPD's new servce model, beng ntegrated n 2012, wll be a mx of the A and C EMS structures as outlned above. The model they are adoptng wll nclude frefghter paramedcs on all shfts, but transports wll contnue to be provded by a thrd-party transport servce. ALS Personnel A crtcal component of emergency medcne s the varous levels of EMS certfcatons provders may acqure. There are currently fve (5) levels of certfcaton and four (4) of these are Emergency Medcal Techncan (EMT) certfcatons. The hghest level of EMT certfcaton, EMT-Paramedc, s requred n order to provde ALS care. Currently WRFPD has an all volunteer frefghtng force that s 75% EMT-Basc wth the remanng at a frst responder certfcaton. WRFPD wll be hrng 12 career shft personnel from ts volunteer ranks n 2011 of whch sx (6) wll start paramedc school n January of OVer the next 36 months, WRFPD antcpates hrng up to a total of 39 personnel wth a total of 15 ndvduals attendng paramedc school. Once these personnel graduate from paramedc school WRFPD wll have full-tme staffng certfed to provde ALS care. The actual number of ndvduals to be hred wll be determned as the Dstrct determnes the best deployment strategy to serve the changng needs of the communty. ALS Apparatus Under WRFPD's current structure, ALS care and transport s provded by Prdemark. Wth the addton of ALS apparatus, patents wll receve ALS care approxmately 33% sooner than under the current model. 3 nternatonal Assocaton of Frefghters, "Prehosptal Emergency Medcal Response: The Role of the Unted Staton Fre Servce n Delvery and Coordnaton " WRFPD EMS: Analyss of nfrastructure and On-Gong Management 31 Page 1 j 1. r.,. 5 r l f R.,.. (

48 Wheat Rdge Fre Protecton Dstrct Analyss of nfrastructure and On-Gong Management Accordng to the Journal of Emergency Medcal Servces (JEMS) Cty Survey, 50.4% of the respondents reported havng ALS 1 st response and ALS transport 4 n a study completed by the Natonal Hghway Traffc Safety Admnstraton (NHTSA) n March of % of respondents ndcated that a fre department arrved on scene frst and 52% reported that the fre servce was the prmary group expected to be on scene frst. However, they also reported that most respondents (60%) have more than one type of agency that s nvolved n frst response as well as transports. s The study covered 405 regons of whch 81 countes were categorzed as large-metropoltan; 100 as small metropoltan; 31 as large non-metropoltan; 112 as small non-metropoltan and 81 as completely rural. (Defntons of these categorzed can be found on page 16 of the report.) Although the study showed that fre departments were often on scene frst, they were dentfed as the prmary transport agency only 36.1% of the tme, wth prvate servces followng at 31%. The study also showed that larger systems are sgnfcantly more lkely to complete transports than ther smaller counterparts. The prmary reason the rural fre departments are less lkely to provde transport servce as part of EMS s a lack of resources. These departments are often volunteer or combnaton and do not have the tax revenue to provde the transport functon. WRFPD plans on addng a tower n 2011 and two (2) medc unts n 2012 to brng the apparatus total up to fve (5). Even though WRFPD wll not be completng transports, t s choosng to add medc unts snce they are sgnfcantly less expensve to purchase, staff, and operate. ALS Equpment n order to provde ALS 1 st response, not only does at least one respondng fre department personnel need to be EMT-Paramedc certfed/ but the apparatus used n the response must have the equpment requred by the Colorado Department of Publc Health and Envronment (CDPHE). Ths equpment, as outlned n the secton of the CDPHE Rules pertanng to Emergency Medcal Servces Dvson has four (4) man categores of equpment requred to be consdered ALS equpped. WRFPD wll have at a mnmum two (2) apparatus ALS equpped by the end of ALS nfrastructure nfrastructure s the technology and tools used to ncrease the effcences of the processes used by the staff. For WRFPD the nfrastructure needed to support ALS 1 st response ncludes operatng standards anq procedures and oversght of all EMS personnel ncludng Paramedcs and performance of any thrd-party transport agency. Ths oversght also ncludes on-gong tranng for the varous EMT certfcaton and EMS performance metrcs to ensure that the new model s meetng the demands of the communty and that t remans cost effectve. 4 JEMS, February 2008 ssue: 2007 JEMS 200-Cty Survey s the Status QUo Acceptable? 5 U.S. Department of Transportaton, Natonal Hghway Traffc Safety Admnstraton, "Confguraton of EMS Systems: A Plot Study". WRFPD EMS: Analyss of nfrastructure and On-Gong Management 41 P a ge

49 Wheat Rdge Fre Protecton Dstrct Analyss of nfrastructure and On-Gong Management n order for ths nfrastructure to be flexble wth the changng demands of the communty and wth changes n emergency medcne, updates wll need to be mplemented quckly and effcently between WRFPD and Prdemark. Ths enables both organzatons to have the best practces and best tools wth the least cost. These changes wll occur quckly and more effcently when all partes nvolved are famlar wth EMS best practces. Decson and mplementaton tme are greatly mnmzed when both organzatons are famlar wth and able to stay abreast of current best practces as a part of dong busness, snce tme wll not be taken away to educate decso'n-makers on the fundamentals of EMS and on the changes n the ndustry as to what provders need to stay current. By streamlnng oversght t keeps costs reasonable and enables the Dstrct to be flexble to the needs of the communty. Thrd-Partv Transport Provder Under the current and new model beng adopted by WRFPD, all transports wll contnue to be provded by a thrd-party. n the Journal of Emergency Medcal Servces (JEMS) February 2011 ssue the 2010 JEMS 200-Cty Survey stated that of the respondents, 47% reported usng a prvate company to complete transports wth 35% beng completed by fre departments. These results are n-lne wth the trend reported n NHTSA report that typcally larger fre-departments are usng the full fre-based EMS whle smaller organzatons are usng thrd-party ALS transport provders. Even though WRFPD s addng apparatus and personnel to provde ALS response, ths new model does not lessen the Dstrct's need to have a thrd-party transport provder. The Dstrct does not currently have the resources needed to set up the nfrastructure to complete transports. Some of ths addtonal nfrastructure would nclude electronc patent care reportng (epcr) software, tough books or tablets for feld use, bllng software, and addtonal admnstratve staff. n addton, research has found that non-government EMS transport provders are able to provde ths servce at a lower cost 6. Performance Metrcs Movng to an ALS 1 st response has benefts to the communty along wth costs of mplementng and mantanng the system. Snce WRFPD wll be one of two agences that wll be provdng ALS response and care, t s crtcal to ensure that the qualty of care provded by the two agences s consstent and unform. The most effectve way to accomplsh ths s to develop performance metrcs around the key components. Some of the crtcal performance metrcs other EMS provders use nclude response tme, cl ncal metrcs, fnancal metrcs, fleet metrcs and customer satsfacton. WRFPD wll need to determne whch performance metrcs are needed to ensure that ALS 1 st response s meetng the demands of the communty and that patents are recevng the qualty of care expected wthn the standards requred. Some of the performance metrcs WRPFD may consder nclude, but are not lmted to: 6 JEMS, February 2008: 2007 JEMS 200 Cty SU/vey, s the Status Quo Acceptable? WRFPD EMS: Analyss of nfrastructure and On-Gong Management S P age f.,....

50 Wheat Rdge Fre Protecton Dstrct Analyss of nfrastructure and On-Gong Management Cost of ALS per call Emergent and Non-Emergent Response Tme Results and Varance Reports How often a patent receves CPR pror to the EMS crew arrvng on scene EMS Customer Satsfacton Surveys ALS Apparatus Productvty Rato Qualty Assurance (QA) Qualty mprovement (QJ) n addton to the performance metrcs, WRFPD s gong to establsh an Advsory Board to revew EMS calls, assst n resolvng operatonal or care problems and make recommendatons to WRFPD on how to mprove the overall EMS care provded by the Dstrct. Havng all EMS components managed by one organzaton wll enable ths Advsory Board to have more control over changes that need to be made and be able to be mplement these changes faster. The Advsory Board wll be headed by the Dstrct's Medcal Drector, Dr. Jeff Beckman. Ths means that the patents wll beneft from these changes sooner than when multple organzatons are nvolved wth the management of EMS. The Advsory Board's fndngs, along wth the performance metrcs captured by both EMS provders, wll need to be reported monthly to the WRFPD leadershp. Consstently reportng the results enables problems to be address quckly and effcently, whch saves the Dstrct money and tme. On-Gong Management of EMS The management Guru Peter Drucker s often credted wth sayng "f you can't measure t, you can't manage t". The prncple behnd ths s that good data s needed to make a good, sustanable decson. As many. EMS reports and artcles over the past ten years have ponted out, the EMS ndustry struggles wth measurng ts performance. 7 f experts n the EMS feld struggle wth how to best measure and manage EMS, how does an organzaton that does not possess ths expertse successfully manage EMS? The key areas of successful EMS management nclude the on-gong montorng of performance metrcs, qualty assurance (QA) and qualty mprovement (Q) processes and the reportng of the results to the Fre Chef, the Medcal Drector and the Dstrct's Board of Drectors. Wthout ths ongong oversght patent care may slde and costs related to provdng the servce may become too hgh. Successful management of EMS also ncludes understandng the challenges facng the ndustry and the challenges of beng a paramedc n the feld. The organzaton responsble for managng an EMS provder must be able to actvely determne what performance metrcs should be reported to ensure that the servce beng provded meets ts commtment to the communty. Not only does the EMS expertse assst n montorng and understandng the mplcatons of varous performance metrcs, t s requred to ensure the EMS transport provder's contract 7 U.S. Department of Transportaton, Natonal Hghway Traffc Safety Admnstraton, "Confguraton of EMS Systems: A Plot Study" and 2007 JEMS 200-Cty Survey. WRFPD EMS: Analyss of nfrastructure and On-Gong Management 61 Page

51 Wheat Rdge Fre Protecton Dstrct Analyss of nfrastructure and On-Gong Management s n the best nterest of the communty. Management of EMS ncludes updatng the thrdparty contract annually so that t s algned wth the current expectatons for EMS. WRFPD would lke to update the thrd-party servce agreement at the next renewal perod to be more smlar to a neghborng Cty's agreement. Followng s a chart outlnng the current contract between the Cty of Wheat Rdge and Prdemark versus the neghborng Cty's contract wth Prdemark. Only some of the dfferences are outlned n the chart snce the neghborng Cty's agreement s approxmately 88% longer than the Cty of Wheat Rdge's agreement. ALS Transeort Provder Contract Provson Comparson Cty of Wheat Rdge. Neghborng Cty8 Polcy: The Provder agreed to partcpate n meetngs to revew the response tme results. None None Servce: Provdes the mnutes & seconds for the response tme req urements. None Advsory Commttees: the contract outlnes two dfferent commttees that wll be nvolved v"th QA/Q. Cty's Emergency Yledcal Servces Leadershp Advsory Councl Cty's Performance mprovement Commttee ALS Fre Department Companes; Explans, why the Fre Departmen t wll have ALS Apparatus and ts affect on the ALS transport, provder., Performance Requrements: Deployment : Plan: Outlnes the specfc requrements for deployment strateg es durng peak perods and specfc requrements wthn the deployment strategy. Performance Requrements: Response Tmes: How response tmes are calcula ted Who the tmekeeper s Response tme expectaton for all ambulances Defnton of arrval Emergent and non-emergent response tme requrements by zone type Descrpton of upgrades, downgrades, reassg nments and cancellatons The consequences of fal ng to meet response tme requrements 8 Cty of Aurora Request for Proposal No.: R1307 and Cty of Aurora Servce Agreement, Ambulance Transport Servces WRFPD EMS: Analyss of nfrastructure and On-Gong Management 71 Pag e,. f,,,., t ; n..._._.._._..._._.... _...._..._. _ _. _ _.

52 Polcy: (See above) Wheat Rdge Fre Protecton Dstrct Analyss of nfrastructure and On-Gong Management ; -- No ne Qualty Specfcatons Color, ["larkng and Warnng Devces Fleet Sze Mantenance Lst of cu rrent ambulances n flee t Commttee Partcpaton : Outlnes that.the provder m ust partcpate n commttees are request by the Fre Ch ef. Performance mprovems;.nt.jlnd Audt, Proqram Performance mprovement Programs Qualty Audt and nspectons None None ; Data and nformaton Reportng: Ths ; secton provdes detal ed expectatons o'n the l foll owng areas: Q f'.'10n t hly Response Tme Report Non-Complant Response Report ncdent Reports Performance m provement and Clnca l Reports Co m munty and Publc nformaton Re ports Prehosptal Patent Ca re Reports o Record Requests. Lquda ted Damages: Th s secton outlnes the amount the Provder w ll owe t he Cty when ca ll response requ rements are not met. Th s ncludes: o Per Mnute Damages Fa l ure to Respond Release from tle Scene Fal ure to Report on Scene Requ red Equpment o Ctywde Damages Equpment and Supples 1V1echanca Fa lures Ambulance Staffng G Ambulance Deployment Overall, the current contract s vague and reles on the state and county rules for EMS to be expectaton of results and patent care rather than takng an actve role n the management and expectatons of servces to be provded to ts communty. EMS, lke any professon, has ts own language, performance tools and standards of operaton. Although some of the standards are dctated by the state, many of the detaled WRFPD EMS : Analyss of nfrastructure and On-Gong Management 8 1 Page

53 Wheat Rdge Fre Protecton Dstrct Analyss of nfrastructure and On-Gong Management performance measures need to be developed by the ndvdual agences provdng EMS. When two agences are workng together to provde EMS, performance metrcs need to be ntegrated as wells as patent care expectatons. For successful management of EMS, there needs to be a complete understandng of the ndustry. Utlzng an organzaton that s not profcent n the ndustry to manage an EMS contract may result n lower qualty of care for the communty, dsconnected communcaton between the ALS provders, and longer resoluton to problems. These same results wll occur f too many organzatons are nvolved n the management. Havng an organzaton(s) that s not ntmately famlar wth EMS manage an EMS provder s no dfferent than askng professonal baseball players to play n the NHL Stanley cup fnals. Although the baseball players and NHL players are all hghly sklled and professonal athletes, each sport requres dfferent sklls, knowledge and expertse. j. r WRFPD EMS : Analyss of nfrastructure and On -Gong Management 91 P age _

54 NTERGOVERNMENTAL AGREEMENT AN AGREEMENT AMONG THE CTY OF WHEAT RDGE, THE W.HEAT RDGE FRE PROTECTON DSTRCT, AND PRDEMARK PARAMEDC SERVCES, LLC., FOR AMBULANCE SERVCES. 1.0 PARTES. The partes to ths Agreement are the Cty of Wheat Rdge, a Colorado muncpal corporaton (herenafter referred to as the "Cty"), Wheat Rdge Fre Protecton Dstrct, an ndependent, quas-muncpal corporaton, (herenafter referred to as the "Fre Dstrct") and Prde mark Paramedc Servces, LLC. (herenafter referred to as the "Company") RECTALS AND PURPOSE. The Cty and Fre Dstrct desre to ensure the avalablty of adequate emergency ambulance servce wthn the entre corporate lmts of the Cty of Wheat Rdge, and the boundares of the Fre Dstrct, and the Company agrees to provde such servces pursuant to the terms of ths Agreement. 3.0 TERMS AND CONDTONS. 3.1 Servce. The Company wll mantan a response tme of fve (5) mnutes and thrty (30) seconds on emergency responses 90% of the tme and a response tme of eght mnutes on non-emergency 90% of the tme. The Company shall make avalable a mnmum of one (1) ALS ambulance to respond to calls for medcal assstance wthn the Cty and Fre Dstrct at all tmes. The Company further agrees to make avalable backup ambulances to the Cty and Fre Dstrct wth response tmes of eght (8) mnutes or less. f the Company s unable to respond wth a ba ckup ambulance the Company shall mmedately call another ambulance company to provde the requred ambulance servce and shall mmedately notfy the Cty dspatcher. 3.2 Calls. n consderaton of keepng such ambulances avalable, the Cty and Fre Dstrct agree that except when a helcopter s used, n all cases where a request s made to the Cty or Fre Dstrct for emergency ambulance servce and/or where ambulance servce s found o be needed n the course of nvestgatve or rescue operatons, all such caffs shall be referred to the Company The Company further agrees that t shall respond to all calls drected by the Cty or Fre Dstrct, and shall perform ts dutes under the drecton and control of the requestng agency. 3.3 Complance wth Law and Accredtaton. The Company agrees to comply wth all federal, state, county, and local statutes, regulatons, or ordnances n ts provson of the servces descrbed wthn ths Agreement, and to mantan ts current ambulance lcense ssued by Jefferson County. The Company agrees that ts records and rosters regardng equpment, vehcles, and tranng may be revewed by the Cty or Fre Dstrct durng regular busness hours. 3.4 Communcatons. The Company agrees to mantan communcatons capabltes wth the Cty of Wheat Rdge Polce/Fre Communcatons Center and all polce, fre, and ambulance vehcles and equpment, as we ll as communcatons between the Company's vehcles and the Cty and Fre Dstrct personnel on scene, and to mantan two back-up speed dal lnes contanng the caller dentfcaton feature to the Communcaton Center, all at the Company's expense usng drect telephone lne capabltes. The Company agrees to mantan channels one and two on the frequency of the Company's vehcles and dspatch center. All rados used shall be programmed by LakewoodlWest Metro Area communcaton personnel. 3.5 Medcal Supervson. The Company agrees to utlze a Physcan Advsor agreed upon by the Cty and Fre Dstrct. A Physcan Advsor s defned as a physcan who establshes protocols for medcal acts performed by paramedcs, and who s specfcally desgnated and responsble to assure the competency of the performance of those acts allowed by such paramedcs. The partes hereto agree that ths Secton 3.5 shall be n effect only for the scope of servce detaled n ths Agreement. The Company further agrees to adhere to, as a mnmum standard, the Denver MetropOltan Paramedc Attachment 2 l [..- l

55 Protocols, as amended, wth respect to medcal acts not governed by the protocols developed by the Company Physcan Advsor. 3.6 Rate. The Company shall be allowed to charge patents t's usually and customary rates. A copy of the Company's current rate schedule attached to ths Agreement as Exhbt A Any changes to the rate schedule whch exceed a Denver-Boulder Medcal CP must be approved by the Cty and Fre Dstrct before takng effect. Rates wll be evaluated as part of the performance evaluaton. 4.0 HELCOPTER. t s understood that n cases of extreme emergency, t may be necessary to use a helcopter n leu of, or n addton to, the Company's ground servces. Such medcal decsons to use the helcopter servce shall be made by the polce and/or fre personnel or Company personnel on scene, wth the prmary responsblty for such medcal decson makng restng wth the Company after consultaton wth fre and polce personnel on the scene. 5.0 CONTROL. The Wheat Rdge Polce Department shall have control of all crme scenes to whch the Company s requested to respond. The Wheat Rdge Fre Protecton Dstrct's rankng offcer on scene shall have control of all fre and EMS scenes. Company employees shall follow the orders and drectons gven by the approprate Polce or Fre personnel, as such orders relate to scene control. The Company shall be n charge of all medcal treatment, patent care and transport ssues, and shall consult approprate polce and fre personnel upon arrval at the scene. 6.0 TRANNG. The Company agrees to provde upon request by ether the Cty or the Fre Dstrct and at the Company's own expense, personnel to assst wth the tranng of the Cty polce department personnel and/or Fre Dstrct personnel n the areas of Frst Responder, EMT and CPR classes, along wth approprate CE medcal tranng. These classes shall be held at tmes mutually agreed upon by the partes hereto. 7.0 EQUPMNT 7.1 The Company shall furnsh, at ts own expense, ambulances and accessory equpment. All one-tme use medca equpment expended n the performance of care by Fre DstrcUDepartment personnel shall be repla ced by the Company. 7.2 The Company agrees that Jefferson County or any other lcensng authorty shall have the rght to nspect on an annual bass the Company's vehcles used for performance of ambulance servce, for the purpose of determnng safety standards of the vehcles used and, further, to ensure that the vehcles so used are equpped wth that accessory equpment requred by the Department of Health, and sad equpment shall be n proper workng order for the use n Advanced Lfe Support treatment. A permt ssued by the County or any other lcensng authorty shall be deemed as evdence of sad annual nspectons. 7.3 The Company agrees, when operatng ts ambulance vehcles n an emergency or nonemergency capacty, sad vehcles wll be drven n a safe and prudent manner, n complance wth all State statutes, Cty and County ordnances relatng to the operaton of emergency vehcles. 8.0 COMPANY EMPLOYEES Each crew shall consst of no less than a lcensed paramedc and one qualfed EMT whose qualfcaton meet the gudelnes of the statutes, rules, and regulatons of the Emergency Medcal Servces Dvson of the Colorado Department of Health, as amended, and are acceptable to the Company PhYScan Advsor. 8.1 The Company agrees, whle operatng ts ambulance n and around the Cty and Fre Dstrct boundares, the employee s of the Company shall mantan a professonal atttude and performance standard and level of conduct for Emergency Medcal Techncans and Paramedcs. 8.2 The Company agrees to notfy the Cty and Fre Dstrct wthn thrty (30) days of changes n personnel Staff changes shall never degrade the level of servces provded by the Company. 2.,. l' r. 1, j. 1.

56 9.0 TERM. The partes mutually agree and understand that the term of ths Agreement shall be for a perod of one (1) year from January 2006 thru January 2007 and upon the expraton of sad perod, ths Agreement may contnue for four (4) addtonal one-year perods, subject to the provsons hereof, provded that no event shall ths Agreement contnue for a perod beyond fve (5) years from the date of executon hereof. Sad Agreement shall be renewed for successve one (1) year perods, as provded heren, subject to revew and performance evaluaton by the Wheat Rdge Cty Councl and the Wheat Rdge Fre Dstrct annually. Ths Agreement may be termnated by ether the Cty Counclor the Fre Dstrct, followng sad revew, or pursuant to the provsons of ths Agreement. Unless so termnated, ths Agreement shall contnue n full force and effect. n addton, the Company's performance shall be revewed sem-annually by the Cty, Fre Dstrct and Physcan AdvsoL The partes further agree that the Cty or Fre Dstrct, upon a determnaton that the Company s not performng the agreed upon servces n a reasonable manner and/or n a tmely fashon, shall gve wrtten notce of such dssatsfacton, and falure of the Company to develop and mplement a plan to rectfy substandard practces wthn ten (10) days from recept of notce thereof, shall gve rse to the cancellaton of ths Agreement. Should such determnaton of dssatsfacton result from a partcular ncdent, the Cty or the Fre Dstrct wll attempt to gve oral notce wthn two (2) busness days of the ncdent gvng rse to the dssatsfacton. Upon ssuance of a second notce of dssatsfacton, the Cty or Fre Dstrct may, at ts opton, cancel ths Agreement wthout affordng the Company the opportunty to correct the complaned of substandard practce. 9.1 Nothng contaned heren shall be construed as establshng any oblgaton on behalf of the Cty. and/or Fre Dstrct to make any monetary payment or other subsdy to the Company by vrtue of ths agreement. _ 9,2 Ths Agreement shall reman n full force and effect provded, however, that ether party may termnate ths Agreement sooner, other than for cause, upon one hundred twenty (120) days notce. Th s termnaton provson shall also be applcable to any renewable perod exercsed by the partes. 9.3 f any party fals to comply wth any term of ths Agreement, any other party may termnate ths Agreement mmedately upon wrtten notce ndcatng the termnaton date andlor sue for breach of contract. n such event, the prevalng party n such dspute shall be enttled to ts reasonable costs, ncludng ts attorneys' fees. 9.4 The oblgatons of the Cty and the Fre Dstrct hereunder are expressly subject to the approval of annual appropratons, therefore. n the event of non-appropraton, ths Agreement shall be deemed termnated as of the end of the fscal year for whch funds have been approprated. Termnaton of the Agreement for ths reason shall not consttute a default or breach of the Agreement wthn the scope of Secton 9.3. Ths Agreement does not create or consttute a mult-year fscal oblgaton of the Cty or of the Fre Dstrct ASSGNMENT. Except as provded n ths Secton, the Company may not assgn or subcontract, ts rghts and oblgatons under ths Agreement, wthout ths pror wrtten approval of the Cty and Fre Dstrct POLCY. The Company ag rees to be a partcpatng member n any revew commttee whch s establshed by the Cty, the Fre Dstrct or by the approved Physcan Advsor. Th e purposes of ths commttee shall be to act n an advsory capacty only as to the operatonal and admnstratve terms contaned wthn ths Agreement. Ths wll nclude revew of response tmes and determnaton of allowable exemptons as determned by the commttee LABLTY. Notwthstandng any language to the Contrary contaned n ths Agreement, the Company s an ndependent contractor and s not an employee or agent of the Cty or Fre Dstrct. The Company assumes all lablty for and agrees to ndemnfy and hold harmless the Cty and Fre Dstrct. The Company assumes all lablty for and agrees to ndemnfy and hold harmless the Cty and Fre Dstrct from any and all clams for njures or damages, ncludng attorney's fees, arsng from the Company's performance or lack of performance under ths Agreement except to the extent such clam for njury or damages whch are the drect and proxmate result of an act or order of a polce offcer or other employee or volunteer of the Cty or Fre Dstrct. 3 1 ' j j J. :...